scholarly journals Gynecological aspects in the trends in morbidity and mortality from cancer of the reproductive system

2021 ◽  
Vol 50 (1) ◽  
pp. 27-33
Author(s):  
L. A. Ashrafyan ◽  
E. G. Novikova
Keyword(s):  
Primary Care ◽  
Mammary Gland ◽  
Reproductive System ◽  
Incidence Rates ◽  
Morbidity And Mortality ◽  
The Past ◽  
Diagnostic Center

The article discusses the incidence rates of cancer of the reproductive system organs (mammary gland, endometrium, ovaries, cervix) in Moscow in 1999, analyzes the trend of these indicators over the past 10 years, substantiates the need to revise the principles of the primary care of the obstetric and gynecological service (female consultations), a model of a gynecological diagnostic center is proposed

scholarly journals Burden of heart failure in Flemish general practices: a registry-based study in the Intego database

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e022972 ◽  
Author(s):  
Miek Smeets ◽  
Bert Vaes ◽  
Pavlos Mamouris ◽  
Marjan Van Den Akker ◽  
Gijs Van Pottelbergh ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Sharp Increase ◽  
Incidence Rates ◽  
Downward Trend ◽  
Cardiovascular Medication ◽  
The Past ◽  
Joint Point ◽  
General Practices ◽  
Β Blockers

ObjectivesTo assess the prevalence and incidence of heart failure (HF) stages A to C/D and their evolution over a 16-year period. Additionally, trends in comorbidities and cardiovascular (CV) treatment in patients with HF were studied in the same period.DesignRegistry-based study.SettingPrimary care, Flanders, Belgium.ParticipantsData were obtained from Intego, a morbidity registration network in which 111 general practitioners of 48 practices collaborate. In the study period between 2000 and 2015, data from 165 796 unique patients aged 45 years and older were available.Outcome measuresPrevalence and incidence were calculated for HF stage A, B and C/D by gender. Additionally, the trend in age-standardised prevalence and incidence rates between 2000 and 2015 was analysed with joint-point regression. The same model was used to study trends in comorbidity profiles in incident HF cases and trends in cardiovascular medication in prevalent HF cases.ResultsWe found a downward trend in the incidence and prevalence of HF stage C/D in Flemish general practice between 2000 and 2015, whereas the prevalence and incidence of stage A and B increased. The burden of comorbidities in incident HF cases increased during the study period, as shown by an increasing disease count (p<0.001). The prescription of cardiovascular medication such as renin-angiotensin-aldosterone system blockade, β-blockers and statins showed a sharp increase in the first part of the study period (2000–2008).ConclusionAge-standardised incidence and prevalence of HF stage C/D showed a slightly downward trend over the past 16 years, probably due to the sharp increase in cardiovascular treatment. However, the increasing age-standardised incidence and prevalence of stage A and B, as precursors of symptomatic HF, together with a rising comorbid burden, highlights the challenges we are still facing.

scholarly journals Three decades of eating disorders in Dutch primary care: decreasing incidence of bulimia nervosa but not of anorexia nervosa

2015 ◽  
Vol 46 (6) ◽  
pp. 1189-1196 ◽  
Author(s):  
F. R. E. Smink ◽  
D. van Hoeken ◽  
G. A. Donker ◽  
E. S. Susser ◽  
A. J. Oldehinkel ◽  
...  
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Health Insurance ◽  
The Netherlands ◽  
Bulimia Nervosa ◽  
Incidence Rate ◽  
Mental Healthcare ◽  
Incidence Rates ◽  
The Past

BackgroundWhether the incidence of eating disorders in Western, industrialized countries has changed over time has been the subject of much debate. The purpose of this primary-care study was to examine changes in the incidence of eating disorders in The Netherlands during the 1980s, 1990s and 2000s.MethodA nationwide network of general practitioners (GPs), serving a representative sample (~1%) of the total Dutch population, recorded newly diagnosed patients with anorexia nervosa (AN) and bulimia nervosa (BN) in their practice during 1985–1989, 1995–1999, and 2005–2009. GPs are key players in the Dutch healthcare system, as their written referral is mandatory in order to get access to specialized (mental) healthcare, covered by health insurance. Health insurance is virtually universal in The Netherlands (99% of the population). A substantial number of GPs participated in all three study periods, during which the same case identification criteria were used and the same psychiatrist was responsible for making the final diagnoses. Incidence rates were calculated and for comparison between periods, incidence rate ratios.ResultsThe overall incidence rate of BN decreased significantly in the past three decades (from 8.6 per 100 000 person-years in 1985–1989 to 6.1 in 1995–1999, and 3.2 in 2005–2009). The overall incidence of AN remained fairly stable during three decades, i.e. 7.4 per 1 00 000 person-years in 1985–1989, 7.8 in 1995–1999, and 6.0 in 2005–2009.ConclusionsThe incidence rate of BN decreased significantly over the past three decades, while the overall incidence rate of AN remained stable.

scholarly journals Resolution of the plenum of the interdepartmental scientific council on obstetrics and gynecology, RAMS M3 RF

2021 ◽  
Vol 50 (1) ◽  
pp. 8-8
Author(s):  
Editorial Board
Keyword(s):  
Breast Cancer ◽  
Cervical Cancer ◽  
Mammary Gland ◽  
Reproductive System ◽  
Malignant Tumors ◽  
Main Peak ◽  
Obstetrics And Gynecology ◽  
The Past ◽  
Fast Pace ◽  
Oncological Diseases

Over the past 10 years in Russia, there has been an intensive increase in the incidence of malignant tumors of the reproductive system in women, whose share in the structure of oncological diseases amounted to 36.9%. The current situation is primarily due to an increase in the incidence of malignant tumors of the mammary gland, endometrium, and ovaries. The incidence of breast cancer is growing at a particularly fast pace. Over the past decade, the indicators have increased by more than 70%. The emerging trend towards a decrease in the incidence of cervical cancer in the 70-80s was replaced by a new rise in the period 1990-1999, mainly due to the II-III stages of the disease. The main peak of incidence corresponds to the age period of 56-65 years with a tendency to "rejuvenate" breast cancer up to 35-50 years.

scholarly journals Osteopathic students and graduates matching into pathology residency, 2011–2020

2021 ◽  
Vol 121 (2) ◽  
pp. 149-156
Author(s):  
Ryan Philip Jajosky ◽  
Hannah C. Coulson ◽  
Abric J. Rosengrant ◽  
Audrey N. Jajosky ◽  
Philip G. Jajosky
Keyword(s):  
United States ◽  
Primary Care ◽  
Medical Education ◽  
Accreditation System ◽  
Senior Year ◽  
Medical Specialties ◽  
Residency Programs ◽  
The Third ◽  
The Past ◽  
Residency Match

Abstract Context In the past decade, two changes have affected the pathology residency match. First, the American Osteopathic Association (AOA) Match, which did not offer pathology residency, became accredited under a single graduate medical education (GME) system with the Main Residency Match (MRM), which offers pathology residency. Second, substantially fewer United States senior-year allopathic medical students (US MD seniors) matched into pathology residency. Objective To determine whether there were major changes in the number and percentage of osteopathic students and physicians (DOs) matching into pathology residency programs over the past decade. Methods Pathology match outcomes for DOs from 2011 to 2020 were obtained by reviewing AOA Match data from the National Matching Services and MRM data from the National Resident Matching Program (NRMP). The number of DOs that filled pathology positions in the MRM was divided by the total number of pathology positions filled in the MRM to calculate the percentage of pathology positions taken by DOs. Results Over the past decade, there was a 109% increase in the total number of DOs matching into pathology residency (34 in 2011 vs. 71 in 2020). During this time, there was a 23.3% increase in the total number of pathology positions filled in the MRM (476 in 2011 vs. 587 in 2020). Thus, the percentage of pathology residency positions filled by DOs increased from 7.1% in 2011 to 12.1% in 2020. The substantial increase of DOs in pathology occurred simultaneously with a 94.2% increase in the total number of DOs filling AOA/MRM “postgraduate year 1” (PGY-1) positions (3201 in 2011 vs. 6215 in 2020). Thus, the percentage of DOs choosing pathology residency has remained steady (1.06% in 2011 and 1.14% in 2020). In 2020, pathology had the third lowest percentage of filled PGY-1 residency positions taken by DOs, out of 15 major medical specialties. Conclusion The proportion of DOs choosing pathology residency was stable from 2011 to 2020 despite the move to a single GME accreditation system and the stark decline in US MD seniors choosing pathology. In 2020, a slightly higher percentage of DOs (1.14%) chose pathology residency than US MD seniors (1.13%). Overall, DOs more often choose other medical specialties, including primary care. Additional studies are needed to determine why fewer US MD seniors, but not fewer DOs, are choosing pathology residency.

scholarly journals A retrospective database analysis of burden of IPD and pneumonia in children <15y in Veneto region

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Barbieri ◽  
A Cantarutti ◽  
G Porcu ◽  
T Hu ◽  
T Petigara ◽  
...  
Keyword(s):  
Primary Care ◽  
Average Cost ◽  
Disease Burden ◽  
Disease Incidence ◽  
Population Data ◽  
Interrupted Time Series ◽  
Invasive Disease ◽  
Healthcare Resource Utilization ◽  
Incidence Rates ◽  
Regional Population

Abstract Background IPD and pneumonia are associated with high mortality and healthcare resource utilization (HCRU). This analysis assessed incidence, HCRU and costs of IPD and pneumonia following PCV13 introduction in 2010 in Veneto. Methods IPD, unspecified invasive disease episodes, outpatient pneumococcal and unspecified pneumonia episodes were identified in Pedianet, a pediatric primary care database from 2010-2017. HCRU includes primary care and specialist visits, antibiotic prescriptions, diagnostics, ER visits and hospitalizations. Incidence rates (IRs) were numbers of episodes/1,000 person-years. Standardized regional incidence rates (SRIRs) were calculated by standardizing IRs with regional population data by age and year. Regional expenditures (€/1,000 person-years) were calculated by multiplying SRIRs with average costs per episode. Interrupted time series (ITS) analyses assessed trends in annual IRs in the early and late PCV13 (2010-2013, 2014-2017) periods. Results During 2010-2017, IPD and unspecified invasive disease incidence decreased from 0.40 to 0.31/1,000 person-years. While incidence was numerically lower in 2017 than in 2010, ITS analysis did not detect a significant trend in the early (coef=1.97; p = 0.63) or late PCV13 (coef=0.50; p = 0.90) periods. Average cost per episode was €4206 and average regional expenditure was €171/1,000 person-year. SRIR for outpatient pneumonia decreased from 13.35 to 5.48/1,000 person-year during 2010 to 2017. Pneumonia episodes were associated with 0.29 ER visits and 0.15 short stay and 0.06 long stay hospitalization. Average cost per episode was €345, majority of which was associated with ER visits (€50.8) and hospitalizations (€243.9). Regional expenditures decreased from €12852.31 to €5351.98/1,000 person-year. Conclusions IPD and unspecified invasive disease burden did not change significantly following PCV13 introduction, while disease burden declined for outpatient pneumococcal and unspecified pneumonia. Key messages IPD and unspecified invasive disease burden did not change significantly following PCV13 introduction. Disease burden declined for outpatient pneumococcal and unspecified pneumonia following PCV13.

scholarly journals Primary care-led commissioning: applying lessons from the past to the early development of clinical commissioning groups in England

2013 ◽  
Vol 63 (614) ◽  
pp. e611-e619 ◽  
Author(s):  
Kath Checkland ◽  
Anna Coleman ◽  
Imelda McDermott ◽  
Julia Segar ◽  
Rosalind Miller ◽  
...  
Keyword(s):  
Primary Care ◽  
Early Development ◽  
The Past

scholarly journals Who are we missing with EHR-based smoking cessation treatments? A descriptive study of patients who smoke and do not regularly visit primary care clinics

2020 ◽  
Vol 15 (4) ◽  
pp. 175-180
Author(s):  
Margaret Nolan ◽  
Deejay Zwaga ◽  
Danielle McCarthy ◽  
Christian Kastman ◽  
Timothy Baker ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Provider ◽  
Primary Care Provider ◽  
The United States ◽  
Primary Care Visit ◽  
Patient Portal ◽  
The Past ◽  
Healthcare Settings ◽  
Care Visit ◽  
Tobacco Treatment

AbstractIntroductionMost tobacco treatment efforts target healthcare settings, because about 75% of smokers in the United States visit a primary care provider annually. Yet, 25% of patients may be missed by such targeting.AimsTo describe patients who smoke but infrequently visit primary care – their characteristics, rates of successful telephone contact, and acceptance of tobacco treatment.MethodsTobacco Cessation Outreach Specialists ‘cold-called’ those without a primary care visit in the past year, offering tobacco dependence treatment. Age, sex, insurance status, race, ethnicity, electronic health record (EHR) patient-portal status and outreach outcomes were reported.ResultsOf 3,407 patients identified as smokers in a health system registry, 565 (16.6%) had not seen any primary care provider in the past year. Among 271 of those called, 143 (53%) were successfully reached and 33 (23%) set a quit date. Those without visits tended to be younger, male, some-day versus every-day smokers (42 vs. 44 years, P = 0.004; 48% vs. 40% female, P = 0.0002, and 21% vs. 27% some-day, P = 0.003), and less active on the EHR patient portal (33% vs. 40%, P = 0.001).ConclusionsA substantial proportion of patients who smoke are missed by traditional tobacco treatment interventions that require a primary care visit, yet many are receptive to quit smoking treatment offers.

Incidence of poisoning deaths in Finland in 1971–2005

2008 ◽  
Vol 27 (7) ◽  
pp. 567-573 ◽  
Author(s):  
JE Kivistö ◽  
VM Mattila ◽  
J Parkkari ◽  
P Kannus
Keyword(s):  
Children And Adolescents ◽  
Incidence Rate ◽  
Cause Of Death ◽  
Secular Trend ◽  
Incidence Rates ◽  
Morbidity And Mortality ◽  
Death Rates ◽  
Alcohol Poisoning ◽  
Poisoning Deaths ◽  
Considerable Morbidity

Poisonings cause considerable morbidity and mortality worldwide. However, only few countries have published nationwide statistics on poisoning deaths. Based on the Official Cause-of-Death Statistics of Finland, we investigated the incidence and secular trend of poisoning deaths in Finland in 1971–2005. Alcohol poisoning deaths and other poisoning deaths were analyzed separately. During the 35-year study period, other poisoning deaths (non-alcohol) increased from 2.6/100,000 in men and 1.4/100,000 in women in 1971 to 6.8/100,000 and 3.2/100,000 in 2005, respectively. Alcohol poisoning death rates also increased from 9.6/100,000 in men and 0.7/100,000 in women in 1971 to 16.8/100,000 and 4.2/100,000 in 2005, respectively. In the early 1970s, the incidence rates of alcohol deaths were about 10 times higher in men compared with women, whereas in the last few years of observation, men's incidence rate was only about four times higher. Our study showed that alcohol and other poisoning deaths increased in Finland between 1971 and 2005. Men’s risk was markedly higher than women’s risk, but in the later years, women’s risk was increasing. Poisoning death rates among children and adolescents were low throughout the period.

scholarly journals Tyrosine Kinase Inhibitor Induced Isolated Pericardial Effusion

2015 ◽  
Vol 8 (1) ◽  
pp. 88-93 ◽  
Author(s):  
Vineet Agrawal ◽  
Eric S. Christenson ◽  
Margaret M. Showel
Keyword(s):  
Primary Care ◽  
Pericardial Effusion ◽  
Tyrosine Kinase ◽  
Kinase Inhibitor ◽  
Early Recognition ◽  
Primary Care Providers ◽  
Incidence Rates ◽  
Term Therapy ◽  
Care Providers

Long-term therapy with tyrosine kinase inhibitors (TKI) has resulted in improved outcomes for patients suffering from Bcr-Abl fusion protein-harboring leukemias. As a result, a growing population of patients on TKI therapy present to their primary care providers. In this case, we report on the case of a 62-year-old male who presented with a symptomatic pericardial effusion. After pericardiocentesis, malignancy and infectious etiologies were excluded. The pericardial effusion was attributed to his TKI, with a transition of this medication to a different TKI. A repeat evaluation 1 month following the withdrawal of the offending agent showed no recurrence of his pericardial effusion on echocardiogram. In this report, we will highlight a rare but important side effect of TKI therapy before discussing its purported mechanisms and differing incidence rates. Early recognition of serosal inflammation related to long-term TKI therapy by primary care providers is important in preventing patient morbidity and mortality.

scholarly journals Inadequate Measles, Mumps, Rubella, and Varicella Immunity Among Employees

2021 ◽  
Vol 12 ◽  
pp. 215013272110059
Author(s):  
Stephen Ezeji-Okoye ◽  
Brittney L. Bilodeau ◽  
Divya K. Madhusudhan ◽  
Eileen Pruett ◽  
Sujith Thokala ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Health Center ◽  
Low Cost ◽  
Country Of Origin ◽  
International Travel ◽  
Morbidity And Mortality ◽  
Foreign Born ◽  
Green Card ◽  
Measles Outbreaks

Objectives: The purpose of this cohort study was to evaluate measles, mumps, rubella (MMR), and varicella immunity among a population of adult employees receiving primary care in an employer-sponsored health center. Methods: Participants were eligible for MMR and varicella immunity screening if they were an employee receiving primary care in an employer-sponsored health center between January 1, 2019 and November 1, 2020 who could not provide proof of immunization and 1) had it recommended by their provider, 2) specifically requested immunity testing (often because they had heard of measles outbreaks in their country of origin), or 3) were seen for an immigration physical for their Green Card application. Results: Overall, 3494 patients were screened for their MMR immunity. Of these, 3057 were also screened for varicella immunity. Among these patients, 13.9% lacked measles immunity, 0.83% lacked immunity to all 3 components of MMR, and 13.2% lacked varicella immunity. Among the 262 patients who presented specifically for immunity screening, the rates of lacking immunity were higher for all conditions: 22.7% lacked measles immunity and 9.2% lacked varicella immunity. Conclusion: Given declines in immunizations during the COVID-19 pandemic, there is reason to be concerned that measles and varicella-associated morbidity and mortality may rise. Employers, especially those with large foreign-born populations or who require international travel may want to educate their populations about common contagious illnesses and offer immunity validation or vaccinations at no or low cost.

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